Can We Prevent Patient No-Shows in Radiology?

No-shows can negatively impact both a facility’s financial operations and patients’ health. A group of researchers led by Joshua I. Rosenbaum, MD, a radiologist at the University of Washington, conducted an extensive study to determine the factors that make patients skip appointments and what systems can be put in place to deter no-shows.

Although all specialties encounter no-shows, the reasons why patients miss imaging appointments are probably different from the reasons that prompt them to forego other kinds of medical procedures. For their study published in the Journal of the American College of Radiology, Dr. Rosenbaum and his colleagues looked at patient no-show data from four academic hospitals and imaging facilities between January 1, 2000 and December 31, 2015. They found that out of the approximate 2.9 million patient visits scheduled between that 16-year period, there were 94,096 no-shows, a figure which made up 3.25 percent of appointments.

Mondays and Saturdays had the highest number of overall no-shows, with 3.67 percent and 3.6 percent respectively. Patients were also more likely to miss an appointment during the mornings and early afternoons. Appointments were typically kept if the patient was over 60 years old; younger patients had higher rates of no-shows. Patients between 40 and 59 years old had the highest no-show rate with 3.8 percent.

The researchers found that imaging rates varied across modalities (radiography, mammography, CT, MRI, ultrasound, and nuclear medicine procedures). Radiography had the strongest compliance rates, which might be because those procedures don’t require advanced scheduling. Mammography had the highest instance of no-shows, and the authors deduce that this is “due to its nature as a screening examination and may be further complicated by patient discomfort during the examination, beliefs about the disease or the examination, and differing society screening guidelines.”

Overall, no-shows are more likely to occur when imaging appointments are scheduled too far in advance. Patients will also skip appointments if their symptoms are improving, and don’t feel like an imaging procedure is necessary. The authors suggest that facilities should implement automated appointment reminders so that patients have lead time to cancel or reschedule their visit.